Town of Winthrop : Record of Deaths 1946, Part 82

Author: Winthrop (Mass.)
Publication date: 1946
Publisher:
Number of Pages: 526


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 82


Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).


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(Signature of agent of Board of Health no other) Health Oficer 15/9/40 (Official Designation) ( Date of Issue of Pertoft)/


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


( Month)


(Day)


46 (Year)


19 | HEREBY CERTIFY,


Oct 20


19.46


to


Nic 5


1946


i just saw him alive on.


. 19 46, death is said to


have occurred on tha date stated above, at


11 40


Immediate oause of death


Ecucina y 1 costata


0


IMPORTANT


3 yes


Due to


Due to


Caravana q


Smaal


Other conditions


( Include pregnancy within 3 months of death)


IMPORTANT


Physician Underline the cause to which death should be charged st .. tistically.


20 Was disease or injury in any way related to oogupation of deocesed ?.


if ao, specify


( Signed)


Have adell


M. D.


(Address) 200P teabrott Date 18006 1946


21


Hope


Place of Burial, Cremstion or Removal.


(City or Town)


DATE OF BURIAL


December 9


$6


22 NAME OF


FUNERAL DIRECTOR


ADDRESS


Howard S Quenulet


Recalved and Aled DEG-1-04946


19


( Registrar)


100m-(g)·1.45-15510


extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46. Seotion 10, requires physiolans to insert a reolta! to that offoot. PARENTS


Winthrop


(City or Town)


St.


{give its NAME instead of street and number)


PHYSICIAN - IMPORTANT


(Was deceased a


U. S. War Veteran,


if so specify WAR) 2


St.


( If nonresident, give city or town and State)


Length of stay: In hospital or Institution


( Before death)


(Specify whether)


66


Duration


Mejor findings:


Of operations


Prestala


Date of.


1943


Of autopsy


.


........


What test confirmed diagnosis ?


5


worcester


5


Thet I attended deosased from


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH


A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death . . . Gen. Laws, Chap. 46, Sec. 9.


A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which It has been engaged, insert iu the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary ind the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- ion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- een hundred and seventeen. G. L. Chap. 46, Sec. 10.


No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its gent appointed to issue such permits, or if there is no such board, from he clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving omb to another in the same cemetery, until he has received a permit from he board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, satisfactory written statement containing the facts required by law to be eturned and recorded, which shall be accompanied, in case of an original nterment, by a satisfactory certificate of the attending physician, if any, s required by law, or in lieu thereof a certificate as hereinafter provided. f there is no attending physician, or if, for sufficient reasons, his certificate annot be obtained early enough for the purpose, or is insufficient, a physi- ian who is a member of the board of health, or employed by it or by the electmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- al examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within he commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the indertaker desiring to make such removal shall constitute a permit for uch removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required


by section ten or chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).


1


Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; .. . - General Laws, Chap. 38, Sec. 6.


No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . .. Chap. 114, Sec. 46, G. L., (Tercentenary Edition).


RULES OF PRACTICE


The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:


(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.


(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy. sician is absent from home when the certificate of death is needed.


(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.


Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.


Statement of Occupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, how- ever, designate the occupation by the appropriate terms, as housekeeper -- private family, cook-hotel, etc. For a person who had no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE


RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


-305


after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)


25m-10-'39. No. 8427-g


PARENTS


14 BIRTHPLACE OF


FATHER (City)


Milford


(State or country) Mass


15 MAIDEN NAME


OF MOTHER


Mary Ann Duggan


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Milford


Mass


17 Mary C Nestor Fay


Relation, if any


Informant.


(Address)


19 Wilshire St Winthrop Mas's


A TRUE COPY.


Clifford IsSmith


ATTEST:


(Registrar of city or town where death occurred)


DATE FILED


Dec 9 1946


19


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH ...


Dec 6


1946


(Month)


(Day)


(Year)


19 | HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) Coronary thrombosis


20 Accident, suicide, or homicide (specify)


Date of occurrence .. .19


Where did Injury occur ?. (City or town and State)


Did injury occur in or about the home, on farm, in industrial place, or in public place?


Manner of


Injury


Nature of


Injury


While at work ?


Was there an autopsy ?.


21 Was disease or Injury la any way related to occupation of deceased ?.


If so, specify.


(Signed)


WAR Chapin


. M. D.


(Address)


o.p.f.ld


Date 12-6 1946


22 winthrop winthrop Mass


Place of Burial, Cremation or Removal. (City or Town)


DATE OF BURIAL


Dec 9


1946


23 NAME OF


FUNERAL DIRECTOR


John F O'Maley


ADDRESS


Winthrop Mass


Received and filed


19


JAN 7 1017


(Registrar of City or Town where deceased resided)


1


PLACE OF DEATH


HAMPDEN (County) SPRINGFIELD


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH


SPRINGFIELD (City or town making return)


Registered No.


231.


(If death occurred in a hospital or institution,


St. ( give its NAME instead of street and number)


2 FULL NAME


Ambrose Fay


(If deceased is a married, widowed or divorced woman, give also maiden name.)


19 Wilshire St


Winthrop Mass


St.


Dead on arrival


years


months


days.


(Specify whether)


PERSONAL AND STATISTICAL PARTICULARS


3 SEX Male


4 COLOR OR RACE


White


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word) Married


5c If married, widowed, or divorced


HUSBAND of


Mary C Nestor


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


40


Years


6 Age of husband or wife if alive.


7 IF STILLBORN, enter that fact here.


8 46


AGE


Years.


Months.


Days


If less than I day Hours


Minutes


Usual


9 Occupation:


Manager


Industry


10 or Businesst


023-01-6111


Il Social Security No.


Brink's Inc-Bank Express


12 BIRTHPLACE (City)


Blackstone


(State or country)


Lass


13 NAME OF


FATHER


James H Fay


(If U. S. War Veteran, specify WAR)


(If nonresident, give city or town and state) In this community1 k yrs. mos. days.


(a) Residence. No ......


(Usual place of abode)


Length of stay: In hospital or institution ..... o.s.pita.l.


No ...


(City or Town) Mercy Hospital-Dead on arrival


wife


(Specify type of place)


1


١


.301 A 1


1


PLACE OF DEATH


Suffolk ... (County )


Winthrop


-


No.


(City or Town) 46 Washington Ave.


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH


To be filed for burial permit with Board of Health or its Agent. 232


Registared No. f (If death occurred in a hospital or institution, SŁ


't give its NAME instead of street and numher)


2 FULL NAME


Sarah L Roberts


(If deceased Is a married, widowed or divorced woman, give also maiden name.)


35 Birch Ka.


St.


(If nonresident, give city or town and State


Length of stay: In nowoitel or Institution


( Before death )


( Specify whether )


years


months


6


days.


In this community 25 yrs.


mon.


dayı


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


4 COLOR OR RACE


5 SINGLE


( write the word)


MARRIED


WIDOWED


or DIVORCED


Widow


5e If married, widowed, or divorced


HUSBAND of


(or) WIFE of


{ Husband's name in full)


6 Age of husbend or wife if elive yeers


7 IF STILLBORN, enter that fect here.


8


11 Years


8


Months


14 Days


AGE


If less then 1 day


Hours


Minutes


Usual


9 Occupation:


Housewife


Industry


At Home


11 Social Security No.


None


chelsea


12 BIRTHPLACE (City)


( Siate or country)


Mass.


13 NAME DF


FATHER


Charles D Addison


14 BIRTHPLACE DF


FATHER (Clty)


(State or country)


England


15 MAIDEN NAME


OF MOTHER


Alma Wheeler


16 BIRTHPLACE OF


MOTHER (City)


(State or country )


Unable To Obtain


17 George Roberts


Relation, if any


Informant ( Address) CITIT House CTIFE ++ Ave. WinthroPOTE OF BURIAL.


I HEREBY CERTIFY that a satisfactory standard certifiosta of deeth was filed with me BEFORE the burial or transit permit was istued ? Walter A. Lakers


(Signature of Agent of Board of Health or other) 12/10/76


(Date of Issue of Peymit)


MEDICAL CERTIFICATE OF DEATH


18 DATE DF


DEATH


December


7.7,


( Month)


(Day)


1946 (Year)


19 | HEREBY CERTIFY,


That i attended deosased from


may 10,


,


1944


to


Decr 7,


1946


I last saw her alive on.


19466 death is said to


have occurred on the date stated above, a


9:20 Pm


Duration


Immediate osuse of death.


Cerebral / de


IMPORTANT


Due to


Due to


Other conditions


( Include pregnancy within 3 months of death)


Mejor findings :


Di operations


Of autopsy


What test confirmed diegnosis ?


Clinical Signs


IMPORTANT


Physician


Underline the cause to which death should he charged « .. tistically.


20 Was disease or injury in any way related to occupation of deceased ? 200 if so, specify ..


( Signed )


....... . M. D.


( Address)


Date De2 10 1946


21


woodlawn


Everett


Place of Burial, Cremation or Removal.


(City or Town)


December 10


22 NAME OF


FUNERAL DIRECTORYceux


ADDRESS


Riway wywoles


Received and Ried. DEC 30 1946


(Oficial Designation)


( Registrar)


100m-(g)-1-45-15510


extract from the taws on back of certificate. if deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physiolans to insert a recital to that offoot. PARENTS


PHYSICIAN . IMPORTANT


(Was deceased 2


U. S. War Veteran,


if so specify WAR)


(a) Residenca. No.


(Usual place of abode)


Nurseing Home


Female


White


10 or Business :


Date of


-


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH


A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.


A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relicf expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.


No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required


by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given aud the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).


Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; .. . - General Laws, Chap. 38, Sec. 6.


No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . .. Chap. 114, Sec. 46, G. L., (Tercentenary Edition).


RULES OF PRACTICE


The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:


(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.


(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is absent from home when the certificate of death is needed.


(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.


Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.


Statement of Occupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, how- ever, designate the occupation by the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE


RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


01 A


-


1


PLACE OF DEATH


Suffolk (County)


Tinthron


(City or Town)


14 Seymour St


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH


To be filed for burial permit with Board of Health or its Agent.


233. ....


St. § (If death occurred in a hospital or institution, { give its NAME instead of street and number)


2 FULL NAME


Mary E. Duffy


( Devine )


PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)


( If deceased is a married, widowed or divorced woman, give also maiden name.)


(a) Rasidenca.


No.


14 Seymour St.


( Usual place of abode)


Length of stay: In Ansoltal or Institution


( Before death)


( Specify whether)


yeara


months


days.


In this community 20 yra.


mos.


dayı.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


Female


4 COLOR OR RACE


White


5 SINGLE


( write the word)


MARRIED


WIDOWED


or DIVORCED Tidowed


5a If married, widowed, or divoroed


HUSBAND of


(or) WIFE of


BartH&'TerietDriein full)


( Husband's name In full)


6 Age of husband or wife if aliva years


7 IF STILLBORN, enter that fact here.


8


82


AGE


Years


Months


Days


If less than 1 day


Hours


Minutas


Usual


9 Occupation :


Housewife


Industry


10 or Business :


Own Home


11 Social Security No.


Galway


12 BIRTHPLACE (City)


( State or country)


Ireland


13 NAME OF


FATHER


Thomas Devine


14 BIRTHPLACE DF


FATHER (City)


Calway


(State or country)


Ireland


15 MAIDEN NAME


DF MOTHER


Helen Ward


16 BIRTHPLACE OF




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